Monthly use of a real-time continuous glucose monitoring system as an educational and motivational tool for poorly controlled type 1 diabetes adolescents

Purpose: Experience with the use of real-time continuous glucose monitoring systems (RT-CGMS) in teenagers with type 1 diabetes mellitus (T1DM) is limited. We aimed to assess the possibility of glycaemic control improvement and to characterize the group of adolescents, who may gain long-term benefits from the use of the RT-CGMS. Methods: Forty T1DM patients, aged 14.6 +/- 2.1 years, with diabetes duration 7.4 +/- 3.6 years and initial HbA(1)c 9.3 +/- 1.5% were recruited. The analysis was based on one-month glucose sensors use, combined with the thorough family support. Patients were analysed in groups according to baseline HbA(1)c: below and above 7.5%, and 10.0%. Comparison between patients with or without improvement in HbA(1)c after 3-month follow-up was also performed. Patients' satisfaction based on the questionnaire was assessed. Results: HbA(1)c level in entire study group decreased after three months, from 9.3 +/- 1.0% to 8.8 +/- 1.6% (P<0.001). In the group with HbA(1)c improvement, reduction was the highest: 9.0 +/- 1.3% vs. 8.0 +/- 1.2% (P<0.001). Only the group with initial HbA(1)c>10% did not achieve significant improvement: 11.2 +/- 0.5% vs. 10.9 +/- 1.1 (P=0.06). In satisfaction questionnaire the lowest scores (negative opinion) were reported by group of patients with initial HbA(1)c above 10%, while the highest scores (positive opinion) were found in the group with improvement of HbA(1)c after 3 month follow-up. Conclusion: Short-term use of CGMS RT, united with satisfaction questionnaire, performed in poorly controlled teenagers with T1DM, can be useful in defining the group of young patients, who can benefit from long-term CGMS RT use in metabolic control improvement.